Clinical meaning
Cryptorchidism (undescended testis) is a condition where one or both testes fail to descend from the abdomen into the scrotum during fetal development. During normal development, the testes form in the abdomen and gradually descend through the inguinal canal into the scrotum, typically completing this journey by the time of birth or within the first few months of life. The descent is guided by a structure called the gubernaculum and driven by hormones including testosterone and INSL3. When this process fails, the testis remains in the abdomen, inguinal canal, or high scrotal position. An undescended testis is exposed to higher body temperature than normal (the scrotum is 2-3 degrees cooler than body temperature), which damages the developing germ cells over time and increases the risk of infertility and testicular cancer later in life. Surgical correction (orchiopexy) is recommended between 6-12 months of age.
Exam relevance
Risk factors: - Premature birth (most significant risk factor) - Low birth weight - Small for gestational age - Family history of cryptorchidism - Maternal smoking during pregnancy - Maternal diabetes - Exposure to endocrine-disrupting chemicals - Twin pregnancy